Provider Demographics
NPI:1215156807
Name:ERICKSON, SUZANNE C
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:C
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 CHAPEL HILLS DR
Mailing Address - Street 2:#300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1022
Mailing Address - Country:US
Mailing Address - Phone:719-955-1233
Mailing Address - Fax:719-599-0575
Practice Address - Street 1:595 CHAPEL HILLS DR
Practice Address - Street 2:#300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1022
Practice Address - Country:US
Practice Address - Phone:719-955-1233
Practice Address - Fax:719-599-0575
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist